Comment by CGMthrowaway
2 days ago
What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body? 2024 meta analysis of seeding I didn't see ultrasound in there: https://pubmed.ncbi.nlm.nih.gov/39605885/
Here is a study on AEs specifically from this type of ultrasound: https://journals.plos.org/plosone/article?id=10.1371/journal...
Quote: "Cavitation detaches cancer cells/emboli from the primary site and thereby releases them into the circulation, leading to metastasis"
What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body?
Welp I put it to you like this - if you DON'T use this then you have a gorillion cancer cells among which very likely one genetically predisposed to adventure throughout the body as turbocancer.
If you use this, or radiotherapy, or whatever, presumably there is just a lump of dead tissue where the cancer was, signifying at best you cured it but at worst, knocked it down - specifically if you knocked it down from a gorillion to a million cells, genereally speaking if the body has been seeded or the tumor persists - the tumor will take longer to rebuild back up where it was. The latter is manifested as another such and such months of life, making the therapy "life extending"
Cancers aren't perfectly optimized to metastasize, and metasteses (rather than, e.g., bulk pressure from the original tumor) are usually what kills you. It's perfectly possible that the procedure kills 90% or 99% of the cells in the original tumor but increases migration of the remaining cells such that the net effect reduces patient survival.
Don't cancer metastases have more to do with cancer mutations allowing the cancer cells to form new tumors? Some cancer types tend do not develop the ability to colonize new tumors while others do regularly.
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> gorillion
i'd never heard of that counter before so i googled it:
> The word "gorillion" is often used by white supremacists and Holocaust deniers in the form of "six gorillion", which mocks the figure of six million Jews that died during the Holocaust.
may want to look at using different verbiage.
Most non-shitty people probably picked it up from Meme stock sub cultures and wallstreetbets
Of course, one should ask themselves why so much of that culture is fed from and feeds into outright hateful people like nazis and Eugenicists and vague wife haters, and conspiracy theorists who "aren't nazis" but sure seem to believe everything is the fault of the jews.
"Gorillion" as I saw it was about the "Ape" context of wallstreetbets discourse. The Ape framing is actually non-hateful, referencing the new Planet of the Apes movies where someone makes a dumb analogy to a bundle of sticks: "Ape together strong"
They are similarly fans of calling people and things retarded, but that was getting reddit itself to nag them. So they switched to "regarded", because they aren't very clever.
Other gems of this community include frequent references to making "wife changing money" and an insistence that after GME totally turns out to not have been a scam and they bring down the entire american economy through literal shenanigans, that they will all collectively be crowned king, and totally won't oppress anyone, but also they relish the expectation that they will be able to smugly say "I told you so" to all the people suffering in their new regime.
They also adore doing the kind of "theory crafting" that is usually done by the most crazy person you know trying to "prove" bill gates did 9/11 because of that wingdings thing from 20 years ago.
But culture leaks, so this person might have just picked it up somewhere.
We simply won’t know until they do the inevitable phase2/3 RCTs. They will need to show that this method helps people survive longer or with better quality of life than the current standard of care.
HistoSonics has studies published with 50 patients. Their upcoming study with 5000 liver patients obviously will give more information, but we already have some.
And with that said, these studies are more relevant than the top of thread linking to a review from 2011 looking at papers from 2005-2006 for ultrasound cavitation causing metastases.
...they also appear to have been acquired by an investment group this past year:
https://www.fusfoundation.org/posts/transformational-milesto...
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>>> ... the study found that removing the parachute prior to jumping led to a shocking increase in mortality among skydivers.
When there's a clear causal mechanism, additional research that doesn't propose a clear resolution to the underlying problem doesn't negate the clear causal mechanism. Releasing a bunch of loose cancer into the body is a clear causal mechanism, so unless you're filtering it or killing the loose cancer somehow, I'm not sure what those studies could tell you that overcomes the underlying problem. And until they address that problem, it's going to be limited to a quality of life type application - stopping the tumor from killing you now with the certainty of metastasis killing you later.
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Chemo post-histrophy would remove any lingering cancer cells effectively. Cancer cells need lots of fuel or they stop replicating, and this is what traditional chemo is great at stopping.
Is the idea that you would need less chemo after the tumor is broken up to remove any remaining cancer cells versus just starting out with chemo to remove the tumor?
Chemotherapy isn't always successful, and depends on the tumor's characteristics, but the idea is yes, less chemo. Histrophy is similar to resection, physically removing a tumor. I've seen chemo options for both scenarios with resectable cancers. For example, hormonal therapy is usually prescribed after resectable breast cancer, regardless of outcome. Or, chemo first to shrink the tumor, and have better surgical margins.
The keto diet is also very good for this because many (but not all) cancer cells can't metabolize ketones. However recent research from Columbia Medical School suggests that it can promote metastasis.
Edited for politeness:
Cancer metabolism isn’t a 2-bit meme. Tumors adapt. If they couldn’t, they wouldn’t metastasize.
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> What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body?
that's discussed in the article
I read it three time and can't see anything related.
they mention at the end that the destruction of tissue exposes proteins normal and abnormal to the immune system, with the abnormal ones no longer hidden by tumor structures. if you then search (kagi, google, etc) for this there are results where this worked fantastically.
Metastasis is not just random tumor cell going for a hike, they are seeded with extracellular vesicles carrying particular mix of microRNAs, growth factors, vimentin and other stuff.
> The mechanical destruction of tumors likely leaves behind recognizable traces of cancer proteins that help the immune system learn to identify and destroy similar cells elsewhere in the body, explains Wood
Seems a little too speculatively worded, IMO.
It's called the abscopal effect; see e.g. https://pmc.ncbi.nlm.nih.gov/articles/PMC8537037/
Yes, we were doing a clinical trial where the primary tumor was irradiated which causes antigen release. The patients were given immune checkpoint inhibitors at the same time to activate immune cells. It's promising but tricky.
If it was true, couldn't you get the same effect by taking a biopsy, fragmenting the cells, and injecting them back in? Like a vaccination, in fact. Somebody must have studied that approach already.
First issue is that tumors don't necessarily have to be highly immunogenic, e.g. there're tumors that don't present many neoantigens on the surface. This means immune cells can't easily recognize them. Second issue is that tumor microenvironment evolves to be immunosuppressive. There're many different signals that regulate immune cells activation and simply having antigen-specific cells isn't enough. But as someone said in a sister thread, what you're describing is a basis for multiple clinical trials that combine antigen release with immune activation.
There were reports that if you inject the goo from melting the tumor into another mouse, that mouse became much more resistant to that class of tumor[1], so...
[1] - https://news.engin.umich.edu/2023/10/these-bubbles-kill-canc...
I assume the immune system probably already reacts to this in a specific way. For example, a major bruise has a lot of broken up cells, but doesn't warrant a big immune response.
Cancer immunotherapy is a whole field of research and treatment, yes.
Exactly my thought.
Major damage tends to cause a much larger immune response than a vaccination. That said, they do have therapeutic cancer vaccines that present proteins from cancer (sometimes patient-specific) with adjuvants to help stimulate the immune response.
Interested layman here: IIUC, immunotherapy is currently the holy grail for difficult-to-treat cancers like pancreatic. There are designer mRNA vaccines available that have ridiculous efficacy, but they must be tailored to each individual and so are extremely expensive (and are currently undergoing trials). mRNA COVID vaccines have been shown in some studies to increase the lifespan of pancreatic cancer patients. So, it's not hard for me to imagine that a treatment that gives the immune system a crack at learning to identify and destroy pancreatic cancer cells will boost survivability.
Part of the freak-out about the Trump admin's attacking of scientific research (including, especially, of mRNA research) earlier in the year is that it threatened these trials.
It seems they are initially focused on pancreatic cancer, which has a very low survival rate ~14% [1].
In theory, this may mean that metastisizing this tumour could destroy it in the pancreas, but allow the cells to spread to more treatable locations?
1 - https://www.canceraustralia.gov.au/cancer-types/pancreatic-c...
?? HistoSonics first target was the liver, second was kidney. Pancreas is the third organ they’ve targeted.
It would not be the first therapy that may promote spread while curing the primary site. Hopefully there are measures to assess the cost / benefits.
For sure. Goes without saying in any cancer treatment that cost/benefit is a prime consideration. Still, that will not stop me from asking the question. You can't do that analysis without the answers after all.
Stopping you wasn't my intent. I'm just a visitor sharing some stuff.
If any medical professional could give answers that would be neat.